Taking heart from success: BHF Scotland

The life-and-death importance of cardiac resuscitation skills was demonstrated to James Jopling in the most personal way within a fortnight of starting his new job.

His uncle had a cardiac arrest while sitting in a crowd at a football match and his life was saved by paramedics who gave him CPR right there and then. The 76-year-old was then taken to hospital, and fitted with an ICD, a small device which can treat people with dangerously abnormal heart rhythms.

He was told later that if he had not been at the stadium when his heart stopped, with people skilled in CPR close at hand, he would certainly not have survived.

“It brought home to me, in a way I would never have wished, why it is so critical that we know where defibrillators are and that as many of us are trained in CPR as possible,” says Jopling. “It also underlines the importance of the advances that have been made in medicine in the last 60 years, since the British Heart Foundation was founded. 

“My uncle’s recovered sufficiently to go back to the ground already and meet the team who saved him – which is pretty remarkable.”

Increasing the proportion of the population skilled in CPR has long been a priority for the British Heart Foundation (BHF). It scored a major success last year when local authorities across Scotland responded to its Nation of Life Savers campaign by agreeing to ensure that all schoolchildren are taught CPR skills before leaving secondary school. The roll-out across Scotland is in keeping with the values of Curriculum for Excellence, allowing each school and local authority to deliver it in the context of their local needs. There have been some striking examples of local initiatives resulting from this, such as Renfrewshire Council going beyond CPR to look at defibrillator placements within the local authority area.

Another recent campaigning achievement was helping secure legislation for an opt-out system of organ donation in Scotland.
But at the core of the BHF’s work is investment in research to better understand how to treat heart and circulatory diseases. Its vision is a world free of the fear of heart disease and circulatory diseases such as type 1 diabetes, stroke and vascular dementia, and it is the largest independent funder of heart and circulatory disease in the UK.

Last year, the BHF was funding nearly £66m of active ongoing research in Scotland, across 139 projects. The BHF Centres of Research Excellence in Glasgow and Edinburgh each received new BHF funding last year alone, of £3m.

Jopling took the helm at BHF Scotland in January, having previously been director at Breast Cancer Now and executive director at the Samaritans in Scotland.

The Stirling University business studies graduate has worked almost exclusively in the third sector, having started off as a volunteer for Oxfam in Scotland, working with the then deputy director Iain Gray (now Scottish Labour education spokesman), before moving on to a paid role at Oxfam in Oxford. He has also held senior posts at Shelter Scotland and Cancer Research UK.

He arrives at the BHF just as the Scottish Government is preparing its next 10-year strategy on cardiovascular disease, an important moment in the ongoing fight against one of the country’s biggest health challenges. The last 20 years may have seen dramatic improvements in death rates from coronary heart disease (mortality fell by 37.6 per cent between 2006 and 2015) but it remains one of the biggest causes of death in Scotland.

He says: “Fifty years ago, seven out of 10 people in Scotland who were admitted to hospital with a heart attack died; now seven out of 10 will survive, but we still don’t think that’s good enough, so we need to understand how to close that gap so that more families can spend more time with the people that they love.

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“There are about 720,000 people living in Scotland today with a heart and circulatory disease. We now have to work out how to address the needs of a population who are living through and beyond heart disease, living with heart failure as a condition, and how to best manage and support those people so they can have the best quality of life.

“I’ve met a number of patients with a number of conditions in my time here and those people were leading full and connected lives with their families and friends, and then a heart attack or associated condition led to serious illness and recovery. I don’t think we’re close to dealing with that in the best way we want to. There’s still so much more to do.”

He adds: “This is why BHF Scotland is leading a national conversation on the future vision for driving improvement in diagnosis, care and treatment of heart and circulatory disease.”

BHF Scotland is helping to shape the cardiovascular disease strategy. “We are perfectly positioned to join the research, clinical and patient communities together, and work alongside the Scottish Government to ensure our future direction is both informed and coherent, to deliver the best possible outcomes for those at risk of and living with heart and circulatory disease.”

Identifying people at risk of heart and circulatory diseases is vitally important to head off heart failure and heart disease before it happens. Jopling highlights two examples of the BHF’s work on this. The first is a project called SCOT-HEART 2, a study led by the University of Edinburgh of 6,000 Scots to test whether CT scans are a better indicator of heart attack risk than the usual profiling based on risk factors like weight, smoking and blood pressure. “We need to get better at trying to understand who’s at risk and who isn’t so we can better treat those who are at risk and not give unnecessary medication to those who aren’t.”

The BHF also wants to see blood pressure testing become much easier to access in the community, in leisure centres, libraries, football grounds, pharmacies and elsewhere. Jopling explains why: “One of the things I’ve learned from this and other roles within Scotland is that we can all be reluctant sometimes to visit our GP. Sometimes making that appointment, having that discussion, is something we’re worried about, so if we can find alternative settings for blood pressure checks which help people get over that, then that can only be a good thing.”

High blood pressure, a risk factor for coronary heart disease and other conditions, rarely has noticeable symptoms, hence the importance of testing.

The BHF is one of the UK’s largest charities and that allows it to dream big. Jopling is excited about the charity’s programme, the Big Beat Challenge, which is a global competition offering a single research award of £30m to scientists who design the most compelling proposal for a breakthrough solution to a significant problem in any heart or circulatory disease. “It’s for the greatest minds to tackle some of the most significant challenges around heart disease,” says Jopling. “Letting world-class scientists come to us to compete for this research award, is something really transformational. We’re down to the last four now which are currently being worked through. It’s really exciting to be part of a charity that commits to something so ground-breaking.”

To Jopling, one of the most impressive aspects of the charity’s work is its vital relevance to the population it serves: “One of the challenges in the past in other charities working in Scotland has been to evidence the impact of your work on the ground in Scotland when it’s a UK-wide body,” he reflects, “but with the BHF, it’s absolutely clear the impact and investment we’re making in cardiovascular research and understanding other circulatory diseases right here in Scotland.”

It’s a source of pride to him that so many world-leading experts are based here in Scotland. “I think the BHF’s role in Scotland is to bring as much of that understanding and insight to the general public, decision-makers and policy-makers as we can, and tell better and more compelling stories about why this is such a critical area for the future health of people in Scotland.”

None of it would be possible without fundraising activities, which raised £10.1m in Scotland last year through events such as Kiltwalks. Across the UK, the BHF is the largest seller of furniture bar none and in Scotland alone, £18.3m was raised last year through the BHF’s network of shops. That visibility has a further benefit: “Knowing that we have a presence on so many high streets right across the country is a really important opportunity to engage.”

So Jopling arrives at a buoyant moment for the BHF, which turns 60 next year. In those six decades, the outlook for people with heart disease has changed enormously and he is convinced that, if the BHF can continue its critically important research, then the years to come will bring momentous change, helping vanquish one of the great blights on Scotland’s health.   •